TRUST ME, DOC, I READ ABOUT IT ON WIKIPEDIA.

Posted in Rants on January 13th, 2009 by Ed

Microsoft Flight Simulator is a very popular PC game and its appeal is based largely on its realism. It gives a nation full of adults who thought as children that it would be really cool to fly an airplane the opportunity to sit before a fake instrument panel in an imaginary cockpit and say things like "Tower, are we cleared for takeoff?" Juvenile thrills abound. If we suddenly thrust an avid Flight Sim player into control of an airliner in mid-flight, he might have some useful information. He could probably identify certain instruments or grab the right lever to lower the flaps, but said flight is ultimately going to end in disaster. Despite its significant realism, no amount of playing the game makes one an airline pilot.

Last week's post about VBAC raises a very interesting question that the advent of the internet hath wrought. Like the gamer who thinks that his simulated experience makes him a real airline pilot, the overwhelming amount of information made available on the internet can easily lead people to overestimate their own capacity for decision-making. Having the world of information at our fingertips is both empowering and deceptive. For every individual who makes better decisions by educating herself there is another who does what Americans do best: consume a small amount of superficial, decontextualized information which he believes makes him an infallible expert.

In recent years medical professionals have noted a disturbing new trend which is illustrated in this recent Canadian study of 300 doctors:

(Some) doctors said many patients are quick to self-diagnose using the Internet, and are often resistant to the physician's diagnosis and course of treatment.

Apparently this phenomenon, the "WebMD effect" if you will, is quite familiar to doctors and nurses these days. I can only imagine how many suburban hypochondriacs walk into the office/ER and offer the name of a condition rather than a list of symptoms. Microsoft released an internal study showing that not only is such self-diagnosis common but it often leads to unduly dire conclusions (headache = basal skull fracture). While some people who played doctor offer cautionary tales of self-diagnosis turned disastrous, my impression is that WebMD continues to serve as the Build-a-Bear Workshop of American healthcare – a one stop U-Diagnose-It site for hypochondriacs, the uninsured, and the "What makes the damn doctors and their fancy book-learnin' think they're smarter than me?" crowd. And WebMD seems like Johns Hopkins compared to what the rest of the internet offers the unwell. My personal favorite: "How to Self-Diagnose Appendicidis" which includes helpful tips like "You feel a pain in your gut."

Americans generally do a terrible job of locating happy mediums. There is a wide, unpopulated gulf between empowerment through knowledge and a dangerously false sense of security and expertise. Tools and information intended to allow Americans to make better, more well-informed decisions quickly jumped the shark and turned into blog posts with gems like "I just went to WebMD for a self diagnosis of a fluttering I feel in my chest at times." Rather than thinking, "I should probably ask a medical professional about my irregular fucking heartbeat" the classic American combination of laziness and arrogance sends people running to the nearest we browser to quite literally cure what ails them.

More information is always better, but it must be kept in context. Having all of the pieces does not mean that one knows how to assemble them. The internet can tell us a lot but it can't make us doctors, lawyers, stockbrokers, Generals, chefs, historians, scientists, and auto mechanics. Bringing the argument back to last week's post, spending time on pregnancy message boards and perusing MyNaturalHomeBirth.com (or something equally amateurish) does not give the reader the ability to pass a qualified medical judgment on anything. Sure, "experts" and professionals are wrong sometimes. However, something tells me that a doctor is right a little bit more frequently than some knucklehead typing "Is VBAC safe?" into a search engine.